YNHH makes history for HIV organ transplantation with first HIV positive liver transplant in CT

Friday, October 1, 2021

New Haven, CT (October 1, 2021) — Yale New Haven Transplantation Center (YNHTC) performed the first liver transplant in Connecticut from a deceased donor that tested HIV-positive to an HIV-positive patient on July 28. The patient, a male in his late 40’s, returned home within 10 days of the successful surgery to transplant a liver from a deceased organ donor. Yale New Haven Transplantation Center received approval for the HOPE in Action Clinical Trial in September 2016.

The HOPE in Action Clinical Trial team led by Dr. Malinis includes transplant surgeon Ramesh Batra, MBBS; hepatologist Jennifer Batisti, MD; infectious disease specialists Lydia Barakat, MD, and Marwan Azar, MD; and Ricarda Tomlin, Yale School of Medicine clinical trials unit manager.

“For years, the unique nature of combined research and clinical collaboration between YNHTC and Yale Medicine has been instrumental in benefiting patients with clinical excellence and pioneering research. This is a real-life success story among many others,” said Dr. Ramesh Batra, who led the surgical team for the HOPE in Action liver transplantation in July.

Although it is the sixth liver transplant performed at YNHTC for a patient living with HIV, this case is the first liver transplant as part of a national clinical trial under the auspices of the 2015 federal HIV Organ Policy Equity (HOPE) Act which reversed the ban on HIV-to-HIV transplantation. Yale New Haven Hospital is the only transplant center in Connecticut and one of only 17 centers in United States with the ability to enroll its patients in the HOPE in Action Clinical Trial, sponsored by the National Institutes of Health. The HOPE in Action study allows organ transplantations for candidates with HIV who are willing to accept organs from donors identified as HIV-positive.

“The HOPE in Action study is extremely important to improving access to transplantation for people who are living longer with HIV and have end-stage renal or liver disease,” said Maricar Malinis, MD, principal investigator for YNHTC.

“People living with HIV now have the potential to become organ donors, and HIV patients waiting for an organ transplant might be able to receive an organ sooner,” explained Dr. Malinis, a Yale Medicine specialist in infectious disease who cares for patients with end-stage organ disease before and after transplantation.

The HOPE Act sets stringent requirements for recipients and donors, who must be age 18 or older. For example, deceased organ donors’ information including their history of HIV treatment and HIV-related infections is reviewed carefully before offering organs to potential donors. Living donors must have undetectable levels of HIV, normal CD4 white blood cell levels, and no opportunistic infections. The HOPE in Action study will evaluate if receiving a kidney or liver transplant from an HIV-infected deceased donor is safe concerning survival and transplant-related and HIV-related outcomes compared to receiving an organ from a deceased donor without HIV infection.

In 2016, Yale New Haven Hospital collaborated with Johns Hopkins University to facilitate the first-ever HIV-to-HIV kidney and liver transplantations in the United States. The YNHTC team harvested the organs from an HIV-positive patient who had consented to be an organ donor at death. The organs were transported to Johns Hopkins Hospital where they were transplanted into two HIV-positive patients on March 19, 2016.

Yale New Haven Hospital (YNHH), part of Yale New Haven Health, is a nationally recognized, 1,541-bed, not-for-profit hospital serving as the primary teaching hospital for the Yale School of Medicine (YSM). Founded as the fourth voluntary hospital in the U.S. in 1826, today, YNHH has two New Haven-based campuses, and also includes Yale New Haven Children's Hospital, Yale New Haven Psychiatric Hospital and Smilow Cancer Hospital. YNHH has received Magnet designation from the American Nurses Credentialing Center, the nation’s highest honor of nursing excellence. YNHH has a combined medical staff of about 4,500 university and community physicians practicing in more than 100 specialties.

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